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Cervical Cancer
Female Gynecologic Cancers
Cervical Cancer
How Common is Cervical Cancer?
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Second most common cancer in women world
wide
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>500,000 new cases/year globally*
In Africa 53,000 women die every year
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In Eastern Africa, leading cause of cancer- related
death
In Eastern and Southern Africa, leading female
cancer affecting women aged 15-44**
*WHO 2008
**Arbyn et al 2011
What Causes Cervical Cancer?
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Virtually all cervical cancer and precancerous changes
to the cervix are caused by a virus called HPV
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HPV is sexually transmitted
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It is the most common sexually transmitted infection in the
world
HPV can infect areas not covered by a condom
Skin to skin contact is sufficient for transmission
Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet.
2007;370:890–907.
Does HPV Always Lead to Cancer?
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No. Most HPV infections are temporary and
resolve on their own without causing cancer.
HPV is like the common cold of the vagina:
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You are exposed to cold virus all the time, but only
become sick sometimes because your immune
system usually protects you
If you do catch a cold, your body tries to fight it and
you often get better without treatment.
If the virus is too strong or your body is weak,
though, the cold may lead to pneumonia.
For HPV, a strong virus or weak immune system
may lead to the persistent HPV that causes cancer.
Risk Factors for Cervical Cancer
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Early age at first intercourse (<20 years)
Multiple sexual partners
Many children
Smoking
HIV
Nutrition
Chronic steroid medication use
Prevention of Cervical Cancer
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There are two main ways to prevent
cervical cancer:
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Prevent infection with HPV
If infected, make sure HPV doesn’t turn into
cancer
How to Prevent HPV Infection
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Vaccine
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Two vaccines available (Cervarix, Gardasil) that
protect that protect against the most common HPV
strains that cause cancer
Most effective if given to adolescents before they
become sexually active
Reduce exposure and boost immune system
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Stop smoking
Reduce number of partners
Delay first time of vaginal intercourse
Use condoms
Eat healthfully
How to Prevent HPV Progression
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Screening for changes in the cervix
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Pap smear
Treating pre-cancerous changes to the
cervix
Pap Smear
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Take cells from the cervix and look at them under the
microscope
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A pathologist decides if “these are normal” OR “these
look like they have been infected with HPV”
Cells that look like they have been infected are “an
abnormal pap smear”
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Abnormal Pap Smears
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The pathologist can grade how abnormal
the cells look
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“Low grade” is a mild abnormality
“High grade” is a more severe abnormality
that needs to be investigated further and
may require treatment.
If the Pap smear is abnormal
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The doctor may want to perform something called
a colposcopy.
During this procedure, the doctor will look at your
cervix using a special magnifying instrument.
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Vinegar can be applied to turn HPV-infected cells white
The clinician takes a sample (biopsy) of the tissue from
abnormal areas
Treating Pre-Cancerous Cells
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Some of the abnormal areas may contain
pre-cancerous cells. A pre-cancerous
cell means that it is not cancerous yet,
but could become cancerous and it
should be monitored or treated
If an abnormality is not very advanced,
the clinician may wait to see if the body
can fight the virus on it’s own.
If the abnormality is advanced, though,
the treatment is to remove or destroy
affected cells using radiation,
chemotherapy, or surgery.